POS0209 CLINICAL AND DIAGNOSTIC SIGNIFICANCE OF INTIMA-MEDIA THICKNESS, LEVELS OF SOLUBLE CELL ADHESION MOLECULES AND CD40 LIGAND IN RHEUMATOID ARTHRITIS PATIENTS WITH LOW CARDIOVASCULAR RISK
Authors: E. Gerasimova, T. Popkova, D. Gerasimova, E. Nasonov
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) is a systemic inflammatory disease leading to significant increase in cardiovascular morbidity and mortality. Development of atherosclerotic lesions of the carotid arteries in RA patients is associated with the accumulation of traditional risk factors and immunological disorders. Objectives To evaluate the detection rate of subclinical carotid atherosclerosis and clinical significance of immunoinflammatory markers in RA patients with low cardiovascular risk (CVR) in comparison with the control group. Methods The study included 275 RA patients (with low CVR and no established cardiovascular diseases) and a control group comprising 100 people without autoimmune diseases. The groups were comparable in terms of sex, age, traditional risk factors, and CVR value. CVR was calculated using the QRISK3 scale. All study participants had a low CVR (QRISK3&lt;20%). All patients and control group members undertook carotid duplex ultrasonography. Atherosclerotic lesions of the carotid arteries are assessed by the detection of of atherosclerotic plaque (ASP) - the cause of IMT ≥ 1.2 mm. Concentration of sIСАМ-1, sVСАМ, and sCD40L in blood serum was determined by enzyme immunoassay using reagent kits and according to Bender MedSystems protocols (USA). Results Carotid ASP were observed more frequently in RA patients (27%) with low CVR than in the control group (17%), p=0.03. ASP were detected more frequently in men with RA than in women with RA (50% versus 24%, p&lt;0.01). The frequency of ASP in RA patients with low CVR did not depend on the disease’s stage or activity. In RA patients, there was a significant correlation between carotid IMT and age (R=0,48), CVR value determined by QRISK3 (R=0,36), level of total cholesterol (R=0,28), LDL cholesterol (R=0,18), systolic blood pressure (R=0,37), diastolic blood pressure (R=0,38), p&lt;0,05 in all cases. No correlation between carotid IMT and blood concentrations of sCD40L, sVCAM, and sIACAM was found in RA patients or controls. A higher concentration of sVCAM was detected in RA patients compared with the control group (1520 [945; 1915] ng/mL versus 790 [605; 1307] ng/mL, p=0.01); and in RA patients with carotid ASP compared with patients without carotid ASP (1680 [1460; 3350] ng/mL versus 1210 [865; 1810] ng/mL, p=0.01). In RA patients with carotid ASP, sCD40L level was associated with carotid IMT (R=0.40, p=0.04) and cholesterol concentration (R=0.38, p=0.01). In RA patients without ASP, sCD40L level was associated with cholesterol concentration (R=0.41, p=0.02) and diastolic blood pressure level (R=0.3, p=0.04). Conclusion Subclinical atherosclerotic lesions of the carotid arteries were observed in a quarter of RA patients with low CVR and were detected at a significantly more frequent rate compared to the control group. The evaluation of carotid IMT is recommended for RA patients with low CVD. These results suggest that there is an association between carotid IMT and traditional CVR factors and immunoinflammatory markers in RA patients. Disclosure of Interests None declared